Professional Documents
Culture Documents
Consultant, Lewis Pediatrics, as well as the publication "Infection Control in the Child Care and Preschool" by Leigh G. Donowitz, M.D. Although the list is quite comprehensive, you should consult with the Director if your child exhibits symptoms of or is diagnosed with an illness that is not addressed in these pages.
Illness Bacterial Illnesses Symptoms Center Procedure Return to Care
Ear Pulling, earache pain, fever Coughing Fever Small water blisters that break easily & crust over, itchy, fever, crankiness
Eye inflammation
With one symptom or low grade fever, observe child Multiple symptoms or fever of 101 or higher, call parent to pick up
After 24 hours of antibiotics OR note from Doctor stating child may return to daycare AND when free from fever After diagnosis that child is not contagious OR until all blisters break and scab (usually 6 days after onset of rash) AND free from fever of 101 degrees or above AND able to participate fully Bacterial - after 24 hours of antibiotics Viral - until symptoms disappear When free from fever of 101 or higher for 24 hours AND able to participate fully
Conjunctivitis
Hand-Foot-Mouth
Disease (Coxsackie)
Respiratory strider Strider with inspiration Fever Lesions that may occur on inside of
mouth, hands, feet,
If free from fever and able to participate, observe child If fever is present, child is having respiratory difficulty or child has difficulty participating in program, call parent to pick up
When lesions are observed, continue to observe child and alert parent
buttocks, fever Itching, scratching of scalp, appearance of live louse, eggs (nits) attached to hairs
Conduct head check to determine the cause of the discomfort Call parent to pick up if nits or lice are present
*It is essential that all clothing, bedding and other vehicles of transmission (car, stuffed animals, etc.) be laundered in hot water and dried on high heat and that all family members be checked and treated when indicated. Items that cannot be laundered should be sealed in a plastic bag for two weeks.
Impetigo
If diagnosed with a non-contagious skin condition, child may return with doctor's note. If diagnosis is impetigo, child may return 24 hours after treatment begins
Influenza
elbows, knees & legs. Blisters that rapidly change to yellow crusted areas Headache, chills, muscle aches, sore
throat, fever
Illness Symptoms Center Procedure Return to Care
Meningitis
Sudden onset of fever, intense headache, nausea, stiff neck, possible rash Runny nose, cough sneezing, malaise low grade fever Increase in frequency & consistency of bowel movements bloating, gas, abdominal pain, blood, lethargy, dehydration, fever of 101 or above Rose-red rash Slapped face appearance may spread to limbs & trunk Vomiting once, with no other symptoms of illness Vomiting once with additional symptoms such as diarrhea abdominal pain or fever or vomiting more than once
After course of treatment (usually 24 hours after treatment begins) AND doctor's written permission to return No exclusion as long as free from fever of 101 or higher AND able to participate When diarrhea is manageable with regular diet AND child is free from fever of 101 degrees or higher
For 1-3 liquid bowel movements, observe child, alert parents For more than 3 liquid bowel movements or movements that cannot be contained to diaper or toilet, call parent to pick up
Fifth Disease
Inform parent. There is no need to exclude the child unless s/he is uncomfortable and not able to participate in group care
No exclusion necessary - once rash appears, child is no longer contagious If child was sent home due to discomfort, s/he may return as soon as able to participate in group activities Free from symptoms, able to eat solid foods, and free from fever of 101 or higher
Gastroenteritis
Illness
Symptoms
Center Procedure
Return to Care
Pinworms
Roseola
Rotavirus
Scabies
Itching around rectum, possible wheezing, coughing, fever, diarrhea, abdominal pain Sudden, high fever, rash on chest and abdomen Sporadic, severe diarrhea & vomiting Itchy, raised areas or burrows around fingers, wrists, elbows arm pits and waistline Extensive scratching, especially at night Sudden illness with vomiting, fever, sore throat, headache, stomach ache, bright red rash Acute inflammation of tongue and mouth White or grayish plaques on mucous membranes Fiery red rash may contain lesions that range from slightly raised red papules to eroded lesions
When rash disappears or with note from doctor indicating child may return to daycare When asymptomatic
Since person to person transmission occurs rarely, child may return once treatment begins
Diaper Dermatitis
No exclusion required